Methods and algorithms for quantitative analysis of metallomic images to assess traumatic brain injury

The primary aim of this thesis is to develop image processing algorithms to quantitatively determine the link between traumatic brain injury (TBI) severity and chronic traumatic encephalopathy (CTE) neuropathology, specifically looking into the role of blood-brain barrier disruption following TBI. In order to causally investigate the relationship between the tau protein neurodegenerative disease CTE and TBI, mouse models of blast neurotrauma (BNT) and impact neurotrauma (INT) are investigated. First, a high-speed video tracking algorithm is developed based on K-means clustering, active contours and Kalman filtering to comparatively study the head kinematics in blast and impact experiments. Then, to compare BNT and INT neuropathology, methods for quantitative analysis of macroscopic optical images and fluorescent images are described. The secondary aim of this thesis focuses on developing methods for a novel application of metallomic imaging mass spectrometry (MIMS) to biological tissue. Unlike traditional modalities used to assess neuropathology, that suffer from limited sensitivity and analytical capacity, MIMS uses a mass spectrometer -- an analytical instrument for measuring elements and isotopes with high dynamic range, sensitivity and specificity -- as the imaging sensor to generate spatial maps with spectral (vector-valued) data per pixel. Given the vector nature of MIMS data, a unique end-to-end processing pipeline is designed to support data acquisition, visualization and interpretation. A novel multi-modal and multi-channel image registration (MMMCIR) method using multi-variate mutual information as a similarity metric is developed in order to establish correspondence between two images of arbitrary modality. The MMMCIR method is then used to automatically segment MIMS images of the mouse brain and systematically evaluate the levels of relevant elements and isotopes after experimental closed-head impact injury on the impact side (ipsilateral) and opposing side (contralateral) of the brain. This method quantifiably confirms observed differences in gadolinium levels for a cohort of images. Finally, MIMS images of human lacrimal sac biopsy samples are used for preliminary clinicopathological assessments, supporting the utility of the unique insights MIMS provides by correlating areas of inflammation to areas of elevated toxic metals. The image processing methods developed in this work demonstrate the significant capabilities of MIMS and its role in enhancing our understanding of the underlying pathological mechanisms of TBI and other medical conditions.2019-07-09T00:00:00

Advanced therapy learning algorithm for SCS

Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2010.Cataloged from PDF version of thesis.Includes bibliographical references (p. 85-87).Spinal Cord Stimulation (SCS) is a technique used to treat chronic pain and has been shown to be an effective method of treatment, both financially and socioeconomically. Stimulating electrodes are surgically implanted into the epidural space, outside the dura, a protective sac filled with cerebral spinal fluid (CSF) surrounding the spinal cord. The thickness of the CSF changes according to body orientation, causing the distance between the stimulating electrodes and the spinal cord to vary. This phenomenon has been reported to cause painful or ineffective stimulation. In order to detect postural behavior and adjust SCS parameters accordingly, a tri-axial accelerometer based algorithm has been developed. The algorithm enables patients to adjust stimulation therapy parameters real-time, associates the patient indicated parameters with a vector, and stores them in a therapy library. Stimulation therapy parameters are then automatically selected by classifying incoming TA data according to the vectors in the therapy library, providing individualized, closed-loop stimulation therapy.by Amanda Dawn Gaudreau Balderrama.M.Eng

Concussion, Microvascular Injury, and Early Tauopathy in Young Athletes After Impact Head Injury and an Impact Concussion Mouse Model

The mechanisms underpinning concussion, traumatic brain injury, and chronic traumatic encephalopathy, and the relationships between these disorders, are poorly understood. We examined post-mortem brains from teenage athletes in the acute-subacute period after mild closed-head impact injury and found astrocytosis, myelinated axonopathy, microvascular injury, perivascular neuroinflammation, and phosphorylated tau protein pathology. To investigate causal mechanisms, we developed a mouse model of lateral closed-head impact injury that uses momentum transfer to induce traumatic head acceleration. Unanaesthetized mice subjected to unilateral impact exhibited abrupt onset, transient course, and rapid resolution of a concussion-like syndrome characterized by altered arousal, contralateral hemiparesis, truncal ataxia, locomotor and balance impairments, and neurobehavioural deficits. Experimental impact injury was associated with axonopathy, blood-brain barrier disruption, astrocytosis, microgliosis (with activation of triggering receptor expressed on myeloid cells, TREM2), monocyte infiltration, and phosphorylated tauopathy in cerebral cortex ipsilateral and subjacent to impact. Phosphorylated tauopathy was detected in ipsilateral axons by 24 h, bilateral axons and soma by 2 weeks, and distant cortex bilaterally at 5.5 months post-injury. Impact pathologies co-localized with serum albumin extravasation in the brain that was diagnostically detectable in living mice by dynamic contrast-enhanced MRI. These pathologies were also accompanied by early, persistent, and bilateral impairment in axonal conduction velocity in the hippocampus and defective long-term potentiation of synaptic neurotransmission in the medial prefrontal cortex, brain regions distant from acute brain injury. Surprisingly, acute neurobehavioural deficits at the time of injury did not correlate with blood-brain barrier disruption, microgliosis, neuroinflammation, phosphorylated tauopathy, or electrophysiological dysfunction. Furthermore, concussion-like deficits were observed after impact injury, but not after blast exposure under experimental conditions matched for head kinematics. Computational modelling showed that impact injury generated focal point loading on the head and seven-fold greater peak shear stress in the brain compared to blast exposure. Moreover, intracerebral shear stress peaked before onset of gross head motion. By comparison, blast induced distributed force loading on the head and diffuse, lower magnitude shear stress in the brain. We conclude that force loading mechanics at the time of injury shape acute neurobehavioural responses, structural brain damage, and neuropathological sequelae triggered by neurotrauma. These results indicate that closed-head impact injuries, independent of concussive signs, can induce traumatic brain injury as well as early pathologies and functional sequelae associated with chronic traumatic encephalopathy. These results also shed light on the origins of concussion and relationship to traumatic brain injury and its aftermath.awx350media15713427811001

A flexible pressure monitoring system for pressure ulcer prevention

Pressure ulcers are painful sores that arise from prolonged exposure to high pressure points, which restricts blood flow and leads to tissue necrosis. This is a common occurrence among patients with impaired mobility, diabetics and the elderly. In this work, a flexible pressure monitoring system for pressure ulcer prevention has been developed. The prototype consists of 99 capacitive pressure sensors on a 17-cm times 22-cm sheet which is flexible in two dimensions. Due to its low cost, the sensor sheet can be disconnected from the reusable electronics and be disposed of after use, suitable for a clinical setting. Each sensor has a resolution of better than 2-mmHg and a range of 50-mmHg and offset is calibrated in software. Realtime pressure data is displayed on a computer. A maximum sampling rate of 12-Hz allows for continuous monitoring of pressure points.Center for Integration of Medicine and Innovative Technolog

Concussion, microvascular injury, and early tauopathy in young athletes after impact head injury and an impact concussion mouse model

Abstract The mechanisms underpinning concussion, traumatic brain injury, and chronic traumatic encephalopathy, and the relationships between these disorders, are poorly understood. We examined post-mortem brains from teenage athletes in the acute-subacute period after mild closed-head impact injury and found astrocytosis, myelinated axonopathy, microvascular injury, perivascular neuroinflammation, and phosphorylated tau protein pathology. To investigate causal mechanisms, we developed a mouse model of lateral closed-head impact injury that uses momentum transfer to induce traumatic head acceleration. Unanaesthetized mice subjected to unilateral impact exhibited abrupt onset, transient course, and rapid resolution of a concussion-like syndrome characterized by altered arousal, contralateral hemiparesis, truncal ataxia, locomotor and balance impairments, and neurobehavioural deficits. Experimental impact injury was associated with axonopathy, blood–brain barrier disruption, astrocytosis, microgliosis (with activation of triggering receptor expressed on myeloid cells, TREM2), monocyte infiltration, and phosphorylated tauopathy in cerebral cortex ipsilateral and subjacent to impact. Phosphorylated tauopathy was detected in ipsilateral axons by 24 h, bilateral axons and soma by 2 weeks, and distant cortex bilaterally at 5.5 months post-injury. Impact pathologies co-localized with serum albumin extravasation in the brain that was diagnostically detectable in living mice by dynamic contrast-enhanced MRI. These pathologies were also accompanied by early, persistent, and bilateral impairment in axonal conduction velocity in the hippocampus and defective long-term potentiation of synaptic neurotransmission in the medial prefrontal cortex, brain regions distant from acute brain injury. Surprisingly, acute neurobehavioural deficits at the time of injury did not correlate with blood–brain barrier disruption, microgliosis, neuroinflammation, phosphorylated tauopathy, or electrophysiological dysfunction. Furthermore, concussion-like deficits were observed after impact injury, but not after blast exposure under experimental conditions matched for head kinematics. Computational modelling showed that impact injury generated focal point loading on the head and seven-fold greater peak shear stress in the brain compared to blast exposure. Moreover, intracerebral shear stress peaked before onset of gross head motion. By comparison, blast induced distributed force loading on the head and diffuse, lower magnitude shear stress in the brain. We conclude that force loading mechanics at the time of injury shape acute neurobehavioural responses, structural brain damage, and neuropathological sequelae triggered by neurotrauma. These results indicate that closed-head impact injuries, independent of concussive signs, can induce traumatic brain injury as well as early pathologies and functional sequelae associated with chronic traumatic encephalopathy. These results also shed light on the origins of concussion and relationship to traumatic brain injury and its aftermath